Skin Cancer Treatment Options

Non-Melanoma Cancer Treatment

The most common non-melanoma skin cancers — basal cell carcinoma and squamous cell carcinoma — can be treated in several ways:

  • Cryosurgery (also called cryotherapy) involves liquid nitrogen to destroy external tumors through extreme cold temperatures. It is applied with a cotton swab or via a spray.
  • Photodynamic Therapy (PDT) is the use of a specialized light source in combination with a drug that is applied to the skin cancer over the course of hours or days. The drug is activated by the light source and kills the cancer cells. It is most often used for pre-cancerous growths known as artinic keratosis but can also be used when skin cancer surgery has been unsuccessful.
  • Topical chemotherapy is the application of a chemotherapy drug applied directly to the skin cancer via a cream or ointment (instead of being administered orally or intravenously). Topical chemotherapy is usually used for very early skin cancers or pre-cancerous artinic keratoses.
  • Laser surgery is the use of a beam of laser light to eliminate cancer cells. Laser surgery is most commonly an option for early basal cell carcinomas and squamous cell carcinomas.
  • Immune response modifiers are drugs that boost the body’s ability to fight cancer. One immune response modifier, interferon, can be injected directly into a tumor when surgery isn’t possible. Scripps was a pioneer in this area as the first San Diego health-care provider to use interferon to treat basal cell carcinomas.
  • Mohs micrographic surgery is the removal of thin layers of skin until only cancer-free tissue remains. The procedure is designed to conserve healthy tissue and minimize scarring— especially for tumors on or near the nose, eyes, ears, forehead or scalp. Most tumors require one to three Mohs sessions for complete removal of skin cancer cells. Mohs micrographic surgery provides the best cure rate for basal cell carcinomas, according to the American Cancer Society. It also can be performed for squamous cell carcinomas with good cure rates.
  • Excision surgery is the removal of a tumor and an area of tissue surrounding the tumor (referred to as a “safety margin”). The preservation of healthy tissue is less of a priority with excision surgery. Following the surgery, a pathologist examines a sample of the safety margin tissue for cancer cells to make sure they are no longer present.
  • Electrodesiccation and curettage is most frequently used for small basal cell carcinomas that do not require an excision. The physician scrapes away the tumor down to its base using a sharp curette before electrodesiccation is performed to seal the wound through use of high-frequency electric current.

Melanoma Skin Cancer Treatment

Melanoma skin cancer is treated through one or more of the following: surgery, immunotherapy, radiation therapy or chemotherapy.

Surgery for melanoma

  • Wide excisions are performed after a skin biopsy to ensure all cancer cells are gone. This procedure is not considered major surgery and has proven successful in curing most thin melanoma growths. After the skin is numbed with a local anesthetic, additional skin is cut away from the original melanoma tumor area before the wound is stitched closed. A pathologist then examines that tissue to make sure it is cancer-free. Deep melanomas on toes and fingers may require the affected part of the digit to be removed.
  • A lymph node dissection may be performed if a melanoma has spread and been confirmed through a sentinel lymph node biopsy.

Immunotherapy for melanoma

  • Ipilimumab is a drug administered intravenously for melanomas that have spread to other parts of the body or cannot be successfully removed by surgery.
  • Interferon-alfa and interleukin-2 (IL-2) can be injected or given intravenously with the aim of shrinking advanced melanoma.
  • Interferon-alfa may also be administered as an additional therapy for patients with thicker melanomas that often have cancer cells that have spread to other parts of the body. The goal is to keep the cells from spreading and growing.
  • BCG (bacille calmette-guerin) may be used to help treat later-stage melanomas and is injected directly into the tumors.
  • Imiquimod cream may be used for very early stage melanomas in sensitive areas of the face that could be scarred by surgery.

Targeted therapy for melanoma

  • Drugs vemurafenib and dabrafenib attack a mutated gene known as BRAF protein that instructs melanoma cells to grow and quickly divide. About 50 percent of melanomas have the BRAF protein gene.
  • The drug trametinib attacks the MEK protein, which is related to the BRAF protein. The drug may be combined with dabrafenib.

Chemotherapy for melanoma

Although chemotherapy is not as effective for skin cancers such as melanoma as it is for other types of cancer, it may be recommended to help lessen disease symptoms or extend life for patients who have late-stage melanoma. Chemotherapy can be combined with other immunotherapy drugs.

Scripps Health provides chemotherapy services in several locations throughout San Diego County, including Scripps hospitals, outpatient infusion centers, or in Scripps affiliated physicians’ offices. Learn more about chemotherapy and infusion services at Scripps.

Radiation therapy for melanoma

Radiation therapy is not a frequent treatment for a melanoma tumor that started on the skin, but it may be used on nearby lymph node areas after surgery to try to prevent the cancer from coming back. Radiation therapy may also be used to treat reoccurring melanoma, in either the skin or lymph nodes if the cancer can’t be completely removed by surgery.

Radiation therapy can be provided with the goal of relieving symptoms of late-stage melanoma cancer that has spread to the brain or bones.

Comprehensive skin cancer support services

Scripps Health offers additional services for people with skin cancer including: